Marin public health dashboard spotlights equity gaps

Mar. 24—Marin County's public health division has created an internet dashboard that illustrates health disparities among the county's residents.

The dashboard is part of a larger effort to better address the health of Marin's minority communities.

The Robert Wood Johnson Foundation has ranked Marin County the healthiest county in the state in 13 of the last 14 years. In 2017, it slipped to No. 2, below San Mateo County.

"We have among the longest life expectancy at about 85 years and consistently rank high in county health rankings for that reason," Dr. Matt Willis, Marin County's public health officer, told the Board of Supervisors on Tuesday.

"However," Willis said, "we also stand out for something that is less of a point of pride, and that is we have some of the largest gaps in life expectancy between Marin County communities."

For example, Willis noted that the highest life expectancy in Marin is in Ross, where residents have an average life span of 91.9 years. The county's lowest life expectancy is in Marin City, where the largest share of Marin'sAfrican American population lives. There the average life span is 77.1 years.

Willis unveiled the new dashboard during a Board of Supervisors workshop on the fiscal 2024-2025 budget. He said the idea for the dashboard was sparked by the COVID-19 pandemic.

"What we found was that communities were differently impacted by the pandemic in terms of case rates, access to testing, and access to vaccines," Willis said. "That led to the formation of a new piece of public health infrastructure called community response teams."

The county formed four teams: one to interact with Marin City and the rest of Southern Marin; another that includes the predominantly Latino Canal neighborhood in San Rafael and other parts of the city; a team for parts of Novato, where a substantial number of Latino residents live; and another focused on western Marin, which has a fair number of Latino agricultural workers.

A local nonprofit organization leads each community response team, and the teams consist of at least 10 partner agencies. These agencies include other nonprofits, schools, community health clinics, faith-based organizations, businesses and government entities.

"The community response teams are networks of community-based leaders who understand their community best," Willis said, "and can be our most effective strategic partners in closing gaps."

During the early days of the pandemic, vaccination rates among Marin'sAfrican American residents remained stubbornly low despite county efforts to make getting the shots as convenient as possible by sending mobile clinics to Marin City.

"You have to understand how we feel about vaccinations as it impacted our people from the Tuskegee experiment, and so many other things," said Jahmeer Reynolds, executive director of the Marin County Cooperation Team, the nonprofit that serves as the lead agency for the Southern Marin community response team.

A decades-long joint research project of the U.S.Public Health Service and the Tuskegee Institute began in 1932. The experiment involved 600 Black men — 399 with syphilis and 201 who did not have the disease. The men infected with syphilis were not provided with any effective treatment for the disease over the course of the study, even though penicillin had become the treatment of choice by 1943.

As a result, some of the participants died, went blind, went insane or experienced other severe health problems because of their untreated syphilis.

"So being in the pandemic, this was all new," Reynolds said. "There was a sense of skepticism, like, what's going on?"

Reynolds helped write a research paper on the Southern Marin response team's effort in Marin City during the pandemic. The paper was published in the Journal of Humanistic Psychology and later accepted into the library of the National Institutes of Health.

The paper identifies the response team's partnership with Marin City churches as one of the keys to its relative success.

"It definitely made a big difference," Reynolds said, "mainly because the church is viewed as a safe space."

Pastor Floyd Thompkins of St. Andrew Presbyterian Church in Marin City said, "It took a lot of empathy, trust and grace to work together to meet our goal of getting more people vaccinated."

Today, 12.9% of Marin'sAfrican American population is up to date with its COVID-19 vaccinations. That is higher than the Latino population's 9.3%, but it remains far lower than the 33.4% among Marin's White, non-Latino population.

Willis said vaccine hesitancy among other minority groups in Marin had other causes.

"We learned that concerns around fertility were more common in our Latinx residents," he said. "The community response team active in the Canal included young women who live in that community, who could address those concerns directly. Another barrier was general distrust in government related to immigration."

Each community response team receives $150,000 a year. The funding has been provided by the Coronavirus Aid, Relief and Economic Security Act. The legislation sunsets at the end of June.

"Because this is an effective new structure for driving government and community action," Willis wrote in an email, "health and human services has requested ongoing funding from the county."

The teams meet every two weeks and have moved beyond pandemic response to address overdose prevention, disaster preparedness and access to services such as CalFresh and MediCal.

"We're strategizing now on how to address the fentanyl crisis in addition to diabetes," Reynolds said.

The new dashboard focuses on the same four sectors of the county as the community response teams. The dashboard allows users to look at census tracts within the four zones. In addition to information on life expectancy, it supplies data on mental health, drug overdoses, heart attacks and falls by older residents, as well as a host of socioeconomic measures.

"In order to close gaps, you need to see them," Willis said.

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